What breast implant size is best for adding volume on top of breast for more cleavage as I am fuller on the bottom of breast?

High profile implants provide the greatest upper pole fullness and less lateral projection. Best of luck 

I routinely perform a Vectra 3-d simulation for all of my breast augmentation patients in order to take the guessing game out of breast implant based surgery.  The Vectra 3-d simulation machine takes a picture of YOUR breasts and allows a thorough consultation to be performed showing YOU, the patient, exactly what different implant sizes, shapes, profiles and manufacturers look like on your body.  The simulation will point out any and all asymmetries and give you a chance to pick the size and profile of your implants after you see what they look like on YOUR body.
I highly recommend that ALL breast augmentation patients have this done prior to picking a size for their breast augmentation.

Hello and thank you for your question. The size, shape, and profile of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  There are several advantages
and disadvantages to over vs under the muscle.  Under the muscle has the
advantage of lower capsular contracture rates, less risk of rippling, and
better visualization with future mammograms.  Most patients say that under
the muscle also has a more natural look and feel.  This entire surgery can be performed with a
small incision technique.  Make sure you specifically look at before
and after pictures of real patients who have had this surgery performed by your
surgeon and evaluate their results.   The
most important aspect is to find a surgeon you are comfortable with. I
recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Dear kimmie7787,Upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear more full. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side. Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thanks so much for reaching out! These are all very common questions, and ones that are impossible to answer without an in person exam. I would suggest you start by going on a few in person consultations with experienced board certified surgeons. At your consultations an exam will be done, measurements will be taken and then you can discuss all of your questions and options in detail! best of luck. Dr. Kim

I use the following system:1. Wish photos - this helps you tell the surgeon your goals and frame the conversation around what may or may not be realistic;2.  Measurements of the breast width, nipple-fold distance, sternal notch-nipple distance, and other observations of nipple position, lower pole length and skin quality, which all contribute to figuring out what implant choices will satisfy the dimensional constraints of your anatomy;3. Sizing kits - this allows you to put a top on with sizers in your bra and get an idea of how you look in the mirror and in clothes, to help narrow the selection of implants and empower you to be involved in the choice;4. Surgical simulation software (Crisalix) to show you a number of different styles and sizes on a 3D model of your body, which allows you to share this visualization at home with others and to analyze prospective outcomes from multiple angles.With this approach we rarely get asked to revise our breast augmentations for size or shape issues. This requires in-person consultation to optimize the selection process.

The ideal Implant size cannot be determined by your current bra size alone. It is best to have an in-office evaluation so that careful measurements can be taken to determine the best size implant for your chest diameter, several upper body measurements, and current breast tissue. Once you have the measurements, they are all put together to determine the right implant from the right manufacturer. Breast implants of the same cc's can look and feel extremely different depending on the profile and material. In my office, I have the MENTOR breast implant sizing system where different size molds are used to simulate how you appear in your own clothes and help finalize your decision. Hope this helps!
Johnson C. Lee, MD
Board-Certified Plastic Surgeon
IG: @drjohnsonlee

and find a volume that provides the look you like and then with the help of your surgeon, choose the profile that will give you the cleavage and upper pole fullness you seek.  As for over or under, most of us like under the muscle because it increases upper pole fullness, hides any rippling, produces better mammograms, and the most important reason to me, the risk for contractures are lower under the muscle.  Only bad thing... animation when flexing your chest muscles.

 implant size
The best way to pick implant size is based on your breast and chest width and not the volume. As the implants get bigger, they get wider. When the width of the implant fits the width of your chest, it will look nice and fit your frame. If the implants are too small, you will have a gap between them and they may look too far apart. If they are too wide, they will make you look top heavy as they may be too wide and stick well out past the sides of your chest. There are ways to get a bigger or smaller look. This can be done by picking a different implant profile. The higher the profile, the narrower the base width of the implant. If someone has a very narrow chest and wants to be big, they should consider a higher profile implant. If someone has a broad chest and they do not want to be too big but want to avoid the gap and still have cleavage without projection, they should consider a lower profile implant such as a moderate. There are options in between these such as the moderate plus.  A consultation with a board certified plastic surgeon who takes careful measurements and talks to you about your cup size goals will be able to assist you in your decision. Good luck!
Dr Ennis Destin and Miami Fl

The best cosmetic result in any particular breast
augmentation patient depends on a variety of factors, including: Your
individual anatomy, desired outcome, realistic expectations, a thorough
discussion with the plastic surgeon about the options, and an understanding of
the pros and cons of any particular implant choice. Proper sizing is not just
about the number of cc’s. or the type of implant. The thickness of your tissue,
breast dimensions which include the width, height, and projection, as well as
chest wall width all need to be considered when choosing an implant. Trying on
implant “sizers” of various shapes and volumes while wearing a tight t-shirt,
bra, or bathing suit at a preoperative visit will help you and your surgeon
choose the optimal implant.

Keep in mind that following the advice from a surgeon on
this or any other website who proposes to tell you what to do without examining
you, physically feeling the tissue, assessing your desired outcome, taking a
full medical history, and discussing the pros and cons of each operative
procedure would not be in your best interest. I would suggest you find a
plastic surgeon certified by the American Board of Plastic Surgery and ideally
a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you
trust and are comfortable with. You should discuss your concerns with that
surgeon in person.

Robert Singer, MD FACS

La Jolla, California